Gait Analysis

Total Page:16

File Type:pdf, Size:1020Kb

Gait Analysis Medical Coverage Policy Effective Date ............................................. 4/15/2021 Next Review Date ....................................... 4/15/2022 Coverage Policy Number .................................. 0315 Gait Analysis Table of Contents Related Coverage Resources Overview .............................................................. 1 Electrodiagnostic Testing (EMG/NCV) Coverage Policy ................................................... 1 . General Background ............................................ 2 Medicare Coverage Determinations .................... 5 Coding/Billing Information .................................... 5 References .......................................................... 6 INSTRUCTIONS FOR USE The following Coverage Policy applies to health benefit plans administered by Cigna Companies. Certain Cigna Companies and/or lines of business only provide utilization review services to clients and do not make coverage determinations. References to standard benefit plan language and coverage determinations do not apply to those clients. Coverage Policies are intended to provide guidance in interpreting certain standard benefit plans administered by Cigna Companies. Please note, the terms of a customer’s particular benefit plan document [Group Service Agreement, Evidence of Coverage, Certificate of Coverage, Summary Plan Description (SPD) or similar plan document] may differ significantly from the standard benefit plans upon which these Coverage Policies are based. For example, a customer’s benefit plan document may contain a specific exclusion related to a topic addressed in a Coverage Policy. In the event of a conflict, a customer’s benefit plan document always supersedes the information in the Coverage Policies. In the absence of a controlling federal or state coverage mandate, benefits are ultimately determined by the terms of the applicable benefit plan document. Coverage determinations in each specific instance require consideration of 1) the terms of the applicable benefit plan document in effect on the date of service; 2) any applicable laws/regulations; 3) any relevant collateral source materials including Coverage Policies and; 4) the specific facts of the particular situation. Each coverage request should be reviewed on its own merits. Medical directors are expected to exercise clinical judgement and have discretion in making individual coverage determinations. Coverage Policies relate exclusively to the administration of health benefit plans. Coverage Policies are not recommendations for treatment and should never be used as treatment guidelines. In certain markets, delegated vendor guidelines may be used to support medical necessity and other coverage determinations. Overview This Coverage Policy addresses computerized gait analysis, also referred to as motion analysis. Coverage Policy Computerized gait analysis is considered medically necessary when BOTH of the following criteria are met: • A child or adolescent has a diagnosis of cerebral palsy. • The procedure is performed as part of a preoperative assessment, and the results will be used in surgical planning. Gait analysis for any other indication is considered experimental, investigational or unproven. Page 1 of 8 Medical Coverage Policy: 0315 General Background Gait analysis, also referred to as motion analysis, is the systematic evaluation of the dynamics of gait. It is a process of measuring and evaluating the walking patterns of patients with specific gait-related problems. Observational gait analysis, the standard method of evaluating gait, refers to the visual assessment of a patient’s gait, with specific attention to hips, knees and ankles. Gait analysis by observer assessment does not use any specialized equipment, can adequately assess most conditions, and is used to note gross abnormalities in gait. Gait analysis may also be performed in a gait analysis laboratory using specialized technology. This is also referred to as computerized gait analysis, quantitative gait analysis or clinical gait analysis. This procedure has been used to understand the etiology of gait abnormalities and as part of the treatment decision-making in patients with complex walking problems. It has been most often used for patients with neuromuscular conditions, primarily as part of the surgical decision-making process when all conservative measures have been exhausted and surgical intervention is being considered. Computerized gait analysis is a process by which gait characteristics are measured, abnormalities are identified, causes are suggested and treatments are proposed. It is not intended to replace the clinical examination, but rather serves as an adjunct to understand the impairment better. The treatment decision should be made in the total context of the patient’s condition, physical examination and medical history. The technologies involved in clinical gait analysis include: • Specialized computer-interfaced video cameras that measure patient motion. An initial videotape is recorded to provide documentation of how a patient walks and the patient’s gait pattern. • Passive reflective markers are placed on the surface of a patient’s skin, aligning with specific bony landmarks and joints. As the patient walks along a straight pathway in the laboratory, the locations of the markers are monitored with a three-dimensional motion data-capture system comprising five or six special video cameras, all interfaced with a central controlling computer. An infrared light is reflected from the markers back to the cameras. Marker position data allow for the computation of the angular orientation of particular body segments as well as of the angles between segments (joint angles); these data are collectively referred to as kinematics. • Multicomponent force platforms imbedded in the walkway provide measurement of reaction between foot and ground as the patient walks. The data are assessed directly or used to calculate the load in and across the joints. The joint load is referred to as kinetics. • Electrodes placed on the surface of the skin or inserted as fine wires into specific muscles allow the muscle to be monitored as the patient walks. This is referred to as dynamic electromyography (EMG). This technique measures the electrical potential generated by a muscle when it is activated. This information, along with joint kinematic and kinetic results, is used to assess the gait abnormalities. An extensive physical examination of the patient at rest should be performed. This information may then be correlated with the gait data. The gait analysis will usually take two to four hours to complete. In order to perform gait analysis, the patient must be ambulatory with or without assistive devices for a minimum of 10 consecutive steps. The patient must also be able to follow directions and be cooperative during the procedure. The gait analysis data are often interpreted by a team that includes the orthopedic surgeon; the physical therapist or kinesiologist who collected the data; and, at times, the engineer who collected data or the biomechanical engineer who developed the mathematical models used for processing the data. The information from the gait analysis is used along with results of the clinical examination to identify gait deviations, determine potential causes and determine treatment. The most frequent application of gait analysis is in the treatment of children and adolescents with cerebral palsy, when surgical treatment is being considered. The orthopedic difficulties encountered in children with cerebral palsy are frequently a result of high muscle tone, spasticity and rigidity that prevent normal growth of muscle and cause contractures. Treatment of this condition includes physical therapy, occupational therapy, casting, orthotics and medication. Surgery is often recommended when contractures are severe enough to cause movement problems. Gait analysis may be utilized to determine if surgery is necessary and to determine which Page 2 of 8 Medical Coverage Policy: 0315 surgical procedure is appropriate. There are several published studies regarding the use of gait analysis to provide objective information in the surgical planning process for this condition. Literature Review—Cerebral Palsy Treatment Planning There have been several prospective and retrospective studies that have been published regarding the utilization of gait analysis in the surgical decision-making process in children and adolescents with cerebral palsy (Gough, et al., 2008; Lofterod, et al., 2008; Filho, et al., 2080; Lofterod, et al., 2007; Molenaers, et al., 2006; Kawamura, et al., 2006; Desloovere, et al., 2006; Chang, et al., 2006; Cook, et al., 2003; Kay, et al., 2000; DeLuca, et al., 1997). These studies have demonstrated that the use of gait analysis alters the decision making and changes the treatment that these patients receive, including confirming clinical indications for surgery, and for excluding or delaying surgery that was clinically proposed. A retrospective study evaluated the effect of gait analysis on the amount of surgery children with cerebral palsy undergo (Wren, et al., 2009). The study involved 313 children who received gait analysis and 149 children who received not gait analysis before their initial surgery. After adjusting for differences in age and severity of functional problems, it was found that the gait analysis group had more distinct procedures during the initial surgery than the non-gait analysis group. However, only 11% of the gait analysis
Recommended publications
  • Pes Anserine Bursitis
    BRIGHAM AND WOMEN’S HOSPITAL Department of Rehabilitation Services Physical Therapy Standard of Care: Pes Anserine Bursitis ICD 9 Codes: 726.61 Case Type / Diagnosis: The pes anserine bursa lies behind the medial hamstring, which is composed of the tendons of the sartorius, gracilis and semitendinosus (SGT) muscles. Because these 3 tendons splay out on the anterior aspect of the tibia and give the appearance of the foot of a goose, pes anserine bursitis is also known as goosefoot bursitis.1 These muscles provide for medial stabilization of the knee by acting as a restraint to excessive valgus opening. They also provide a counter-rotary torque function to the knee joint. The pes anserine has an eccentric role during the screw-home mechanism that dampens the effect of excessively forceful lateral rotation that may accompany terminal knee extension.2 Pes anserine bursitis presents as pain, tenderness and swelling over the anteromedial aspect of the knee, 4 to 5 cm below the joint line.3 Pain increases with knee flexion, exercise and/or stair climbing. Inflammation of this bursa is common in overweight, middle-aged women, and may be associated with osteoarthritis of the knee. It also occurs in athletes engaged in activities such as running, basketball, and racquet sports.3 Other risk factors include: 1 • Incorrect training techniques, or changes in terrain and/or distanced run • Lack of flexibility in hamstring muscles • Lack of knee extension • Patellar malalignment Indications for Treatment: • Knee Pain • Knee edema • Decreased active and /or passive ROM of lower extremities • Biomechanical dysfunction lower extremities • Muscle imbalances • Impaired muscle performance (focal weakness or general conditioning) • Impaired function Contraindications: • Patients with active signs/symptoms of infection (fever, chills, prolonged and obvious redness or swelling at hip joint).
    [Show full text]
  • Gait Analysis in Prosthetics by James R
    Gait Analysis in Prosthetics by James R. Gage, M.D. Ramona Hicks, R.P.T., M.A. REVIEW lems faced by lower limb amputees. Inman's measurement techniques included motion pic­ Objective measurement systems which quan­ tures of coronal and sagittal views, as well as tify locomotion have been in use for the past transverse rotations from below using a glass century. But not until World War II, when walkway. Using interrupted light photography, thousands of men returned home to the United the Biomechanics Laboratory team studied the States with amputations, was technology really motion of body segments during gait. Force applied to the understanding of prosthetic gait. plates measured the subject's ground reaction Inman and colleagues1 founded the Biome­ forces, and muscle activity was recorded using chanics Laboratory at the University of Cali­ electromyography (EMG), which measures the fornia to establish fundamental principles of electrical signals associated with contraction of human walking, particularly in relation to prob­ a muscle. Prior to Inman's fundamental studies, prostheses were customized for the individual Temporal and kinematic data, which were col­ amputee, without any particular regard to ra­ lected at slow, free, and fast speeds, showed tional structural design. Inman's goal was to that the hydraulic knees improved the symmetry provide fundamental data essential for the de­ between the prosthetic limb and the sound limb, sign of prosthetic limbs. By analyzing normal especially at the fast and free speeds. This human walking, he and his colleagues laid the finding was true for both cadence and the groundwork for biomechanical analysis of am­ amount of knee-flexion at swing phase.
    [Show full text]
  • Common Gait Deviations in the Patient with Hemiplegia
    Common gait deviations in the patient with hemiplegia Kim Carter, PT, NCS Things to consider • How did the patient walk before? • Any previous orthopedic conditions? • House set up • Where can they practice walking outside of therapy? • Caregiver’s ability (and/or willingness) to help patient Initial Contact • Problems – Ankle • Contacts with forefoot/flat foot – Is the step too short? – Is the gastroc tight? » Stretch in sitting » Stretch in long sit » Stretch in standing » Stretch in supine Initial Contact • Problems – Ankle • Contacts with the forefoot/flat foot – Are the dorsiflexors weak? » Seated exercises » Standing exercises » Supine exercises » Taping » Bracing Initial Contact Initial Contact • Problems – Knee • Flexed at contact – Look at the ankle first – Tone-inability to extend knee with hip flexion at terminal swing – Are the hamstrings tight? » Supine stretch » Long sit stretch » Sitting stretch » Standing stretch Initial Contact • Problems – Pelvis • Rotation – Inadequate advancing of the leg » Manual cues for orientation of pelvis » Muscular tightness Initial Contact • Problems – Trunk • Flexed – Tight hip flexors – May be due to increased plantarflexion • Rotated – May be rotated forward to advance the leg Loading response • Ankle – Foot slap • Weak dorsiflexors – Closed chain dorsiflexion Loading Response • Knee – Hyperextension • May be due to short step • Muscular weakness – Modified stride squats – Standing knee extension against theraband – Affected leg on step, step up with sound side Midstance • Problems – Ankle
    [Show full text]
  • Health Sciences Library New Book List: July - December 2018 Page 1 of 6
    Health Sciences Library New Book List: July - December 2018 Page 1 of 6 Peer support best practice toolkit: a resource for individuals developing and providing peer support programs for families of children with medical complexity and other lifelong disabilities. Contents: 1. Background and models of peer support -- 2. Current HQ759.913 .P43 programs in Ontario: case studies -- 3. Resources to help you get started - - 4. Rapid evidence review: peer support for families of children with disabilities. Holland Bloorview Kids Rehabilitation Hospital. Holland Bloorview Kids Rehabilitation Hospital, [2015]. 1 volume (unpaged). A therapeutic clown emerges: our story of recruitment and training. A full-length documentary film which traces the recruitment and training of the newest therapeutic clown. WB880 .D66 Conceived and written by Helen Donnelly. Directed and edited by Helen Donnelly & Greg Vanden Kroonenberg. Narrated by Diane Savage. Holland Bloorview Kids Rehabilitation Hospital, 2018. 1 videodisc (107 min.) Cognitive rehabilitation for pediatric neurological disorders. Chapter contributed by Holland Bloorview staff: Chapter 6 – Lisa Kakonge WS340 .C63 Locascio, Gianna, editor. Cambridge University Press, [2018]. xi, 263 pages Goal setting and motivation in therapy. Chapter contributed by Holland Bloorview staff: Chapter 5 – Gillian King WS350.2 .G62 Poulsen, Anne A., editor. Jessica Kingsley Publishers, 2015. 269 pages. Qualitative research design: an interactive approach. Maxwell, Joseph Alex, 1941-, SAGE Publications, 2013. xi, 218
    [Show full text]
  • Section I Introduction
    SECTION I INTRODUCTION 1. OVERVIEW The National Center for Medical Rehabilitation Research (NCMRR) was established within the National Institutes of Health (NIH) by legislation (P.L. 101-613) passed in 1990. The Center is a component of the National Institute of Child Health and Human Development (NICHD). The mission of NCMRR is to foster development of scientific knowledge needed to enhance the health, productivity, independence, and quality of life of people with physical disabilities. The primary goal of the Center is to bring the health related problems of people with disabilities to the attention of America’s best scientists in order to capitalize upon the myriad advances occurring in the biological, behavioral, and engineering sciences. This is accomplished in part, by supporting research on enhancing the functioning of people with disabilities in daily life. Periodically the Center also sponsors workshops which allow experts in a field to gather and focus on a topic of interest. This document contains a detailed description of the design, execution, results and interpretation of the workshop “Gait Analysis in Rehabilitation Medicine.” 1.1 Purpose The primary purpose of the workshop, described within this document, was to develop and prioritize a set of recommendations that pertain to the future role of gait analysis in enhancing the function of people with disabilities due to functional limitations of the locomotion system. Although the workshop was entitled "Gait Analysis in Rehabilitation Medicine," the range of topics which gait encompasses is much broader than the classical definition of bi or quadri pedal motion might imply. Gait clinics and laboratories include analysis of many forms of human locomotion which often include the use of assistive devices such as crutches, canes, prosthetics, and wheelchairs.
    [Show full text]
  • Categorization of Functional Impairments in Human Locomotion
    University of Texas at El Paso DigitalCommons@UTEP Open Access Theses & Dissertations 2010-01-01 Categorization of Functional Impairments in Human Locomotion using the Methods of the Fusion of Multiple Sensors and Computational Intelligence Huiying Yu University of Texas at El Paso, hyu@miners.utep.edu Follow this and additional works at: https://digitalcommons.utep.edu/open_etd Part of the Biomedical Commons, and the Electrical and Electronics Commons Recommended Citation Yu, Huiying, "Categorization of Functional Impairments in Human Locomotion using the Methods of the Fusion of Multiple Sensors and Computational Intelligence" (2010). Open Access Theses & Dissertations. 2814. https://digitalcommons.utep.edu/open_etd/2814 This is brought to you for free and open access by DigitalCommons@UTEP. It has been accepted for inclusion in Open Access Theses & Dissertations by an authorized administrator of DigitalCommons@UTEP. For more information, please contact lweber@utep.edu. CATEGORIZATION OF FUNCTIONAL IMPAIRMENTS IN HUMAN LOCOMOTION USING THE METHODS OF THE FUSION OF MULTIPLE SENSORS AND COMPUTATIONAL INTELLIGENCE HUIYING YU Department of Electrical and Computer Engineering APPROVED: ________________________________ Thompson Sarkodie-Gyan, Ph.D., Chair ________________________________ Scott Starks, Ph.D. ________________________________ Richard Brower, M.D. ________________________________ Bill Tseng, Ph.D. ________________________________ Eric Spier, M.D. __________________________________ Patricia D. Witherspoon, Ph.D. Dean of the Graduate
    [Show full text]
  • Use of Osteopathic Manipulative Treatment to Manage Compensated Trendelenburg Gait Caused by Sacroiliac Somatic Dysfunction
    Editor’s Note: Corrections to this article were published in the March 2010 issue of JAOA—The Journal of the CASE REPORT American Osteopathic Association (2010;110[3]:210). The corrections have been incorporated in this online version of the article, which was posted January 2011. An expla - nation of these changes is available at http://www.jaoa .org/cgi/content /full/110/3/210-a. Use of Osteopathic Manipulative Treatment to Manage Compensated Trendelenburg Gait Caused by Sacroiliac Somatic Dysfunction Adam C. Gilliss, DO; Randel L. Swanson, II, OMS III; Deanna Janora, MD; and Venkat Venkataraman, PhD Gait dysfunctions are commonly encountered in the pri - In the present case report, we provide evidence that com - mary care setting. Compensated Trendelenburg gait is a gait pensated Trendelenburg gait may represent a secondary gait dysfunction that was originally described in patients with dysfunction stemming from somatic dysfunction of the weakness of ipsilateral hip abduction. This condition is sacroiliac joints. We also describe evidence of osteopathic thought to result from neuronal injury or myopathy. No manipulative treatment (OMT) resulting in quantitative treatment modalities currently exist for compensated Tren - improvements in the gait cycle. delenburg gait. The authors present a case in which osteo - pathic manipulative treatment may have improved a Tren - Traditional and Osteopathic Gait Theory delenburg gait dysfunction in a man aged 65 years with The gait cycle is divided into two main phases—stance and multiple sclerosis. Evidence of this improvement was swing, each consisting of numerous subphases. 2,3 Traditionally, obtained with the GaitMat II system for measuring the human gait cycle is considered to have six determinants that numerous gait parameters.
    [Show full text]
  • Correlation Between Gait Asymmetry and Leg Length Discrepancy—What Is the Role of Clinical Abnormalities?
    applied sciences Article Correlation between Gait Asymmetry and Leg Length Discrepancy—What Is the Role of Clinical Abnormalities? Sam Khamis 1,2,* , Barry Danino 3,4, Dror Ovadia 3,4 and Eli Carmeli 2 1 Gait and Motion Analysis Laboratory, Department of Pediatric Orthopedics, Dana Children’s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel 2 Department of Physical Therapy, Faculty of Social Welfare and Health sciences, University of Haifa, Haifa 3498838, Israel; ecarmeli@univ.haifa.ac.il 3 Department of Pediatric Orthopedics, Dana Children’s Hospital, Tel Aviv Sourasky Medical Center, 6, Weizmann St., Tel Aviv 64239, Israel; barrydanino@hotmail.com (B.D.); droro@tlvmc.gov.il (D.O.) 4 Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel * Correspondence: khamisam@gmail.com; Tel.: +972-50-5452699 Received: 22 July 2018; Accepted: 16 October 2018; Published: 18 October 2018 Abstract: Reducing the effect of leg length discrepancy (LLD) on gait abnormalities while other abnormal conditions such as spasticity, joint contractures or weak muscle strength are exhibited is challenging. This study aimed to evaluate the impact of mild LLD on lower limb biomechanics, on participants with anatomic LLD with and without other clinical abnormalities. A motion capture system was utilized on 32 participants to measure lower limb kinematics and dynamic leg length (DLL) throughout the gait cycle, calculated as the absolute distance from the hip joint center, either to the heel, ankle joint center, or forefoot. The Pearson correlation coefficient found that LLD was associated with 5 kinematic variables only when LLD appeared with no other clinical abnormalities present (r = 0.574 – 0.846, p < 0.05).
    [Show full text]
  • Primary and Secondary Gait Deviations of Stroke Survivors and Their Association with Gait Performance
    J. Phys. Ther. Sci. 28: 2634–2640, 2016 The Journal of Physical Therapy Science Original Article Primary and secondary gait deviations of stroke survivors and their association with gait performance Hyung-Sik Kim, PhD1), Soon-Cheol Chung, PhD1), Mi-Hyun Choi, PhD1), Seon-You ng Gim, BS1), Woo-Ram Kim, BS1), Gye-Rae Tack, PhD1), Dae-Woon Lim, PhD2), Sung-Kuk Chun, MS3), Jin-Wook Kim, PhD3), Kyung-Ryoul Mun, PhD3)* 1) Department of Biomedical Engineering, BK21+ Research Institute of Biomedical Engineering, College of Biomedical and Health Science, Konkuk University, Republic of Korea 2) Department of Information and Communication Engineering, Dongguk University, Republic of Korea 3) Imaging Media Research Center, Korea Institute of Science and Technology: Seoul 136791, Republic of Korea Abstract. [Purpose] Stroke survivors exhibit abnormal pelvic motion and significantly deteriorated gait perfor- mance. Although the gait of stroke survivors has been evaluated at the primary level pertaining to ankle, knee, and hip motions, secondary deviations involving the pelvic motions are strongly related to the primary level. Therefore, the aim of this study was to identify the kinematic differences of the primary and secondary joints and to identify mechanism differences that alter the gait performance of stroke survivors. [Subjects and Methods] Five healthy subjects and five stroke survivors were recruited. All the subjects were instructed to walk at a self-selected speed. The joint kinematics and gait parameters were calculated. [Results] For the stroke survivors, the range of motion of the primary-joint motions were significantly reduced, and the secondary-joint motions were significantly increased. Additionally, for the healthy subjects, the primary joint kinematics were the main factors ensuring gait perfor- mance, whereas for the stoke survivors, the secondary-joint motions were the main factors.
    [Show full text]
  • USCP Gait Patterns – Rang Lovell & Winter 2Nd Ed
    UNILATERAL SPASTIC CEREBRAL PALSY: GAIT PATTERNS AND SURGICAL MANAGEMENT Jon R. Davids, MD Assistant Chief of Orthopaedic Surgery Director, Motion Analysis Laboratory Shriners Hospital for Children Professor and Ben Ali Chair in Pediatric Orthopaedics Department of Orthopaedic Surgery University of California Davis Medical School Sacramento, CA USA Presenter Disclosure Information JON R. DAVIDS, MD Unilateral Spastic Cerebral Palsy: Gait Patterns and Surgical Management Disclosure Information The following relationships exist: • OrthoPediatrics – Consultant • OrthoPediatrics Foundation for Education and Research – Board Member USCP: Gait Patterns and Surgical Management • Classification of CP – Historical / Critical Overview • Unilateral Spastic CP (USCP) – Definition – Common Deviations – Management Options • Surgical • Orthotic – “A Tale of 2 Unis” Classification of CP • Definitions – Classification: systematic arrangement in groups or categories according to established criteria • https://www.merriam- webster.com/dictionary/classification – Purpose • Incidence/Prevalence • Natural History • Clinical Decision Making • Outcome Assessment Classification of CP • Definitions – Hemiplegia: total or partial paralysis of one side of the body that results from disease of or injury to the motor centers of the brain • https://www.merriam- webster.com/dictionary/hemiplegia – Causes • Normal Brain – Trauma / Infection / Tumor / Vascular • Abnormal Brain Structure – Neuronal Migration Disorders Classification of CP • Definitions – Hemiplegia: total
    [Show full text]
  • The Impact of Increased Femoral Antetorsion on Gait Deviations In
    Journal of Biomechanics 86 (2019) 167–174 Contents lists available at ScienceDirect Journal of Biomechanics journal homepage: www.elsevier.com/locate/jbiomech www.JBiomech.com The impact of increased femoral antetorsion on gait deviations in healthy adolescents q ⇑ Nathalie Alexander a,b, , Kathrin Studer c, Harald Lengnick c, Erika Payne c, Harry Klima c, Regina Wegener a,b a Laboratory for Motion Analysis, Department of Paediatric Orthopaedics, Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland b Department of Orthopaedics and Traumatology, Cantonal Hospital St. Gallen, Switzerland c Department of Paediatric Orthopaedics, Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland article info abstract Article history: Increased femoral antetorsion leads to several gait deviations, and amongst others, an increased knee Accepted 8 February 2019 flexion was reported in mid and terminal stance. Therefore, the purpose of this retrospective study was to identify gait deviations caused by increased femoral antetorsion and to perform subgroup analy- ses based on sagittal knee kinematics. Patients with isolated, CT confirmed increased femoral antetorsion Keywords: (n = 42) and age-matched typically developing children (TDC, n = 17) were included in this study. Patients Coxa antetorta were referred to gait analysis because of gait abnormalities going along with an increased femoral ante- Gait analysis torsion 30°. Kinematic and kinetic data were recorded during 3D gait analysis and three valid gait cycles Principal component analysis were analyzed. Principal component (PC) analysis was used to achieve data transformation. A linear Linear mixed model Hip internal rotation mixed model was used to estimate the group effect of PC-scores of retained PCs explaining 90% of the Knee flexion cumulative variance.
    [Show full text]
  • Purpose Pathological Gait Objectives
    Primary, Secondary and Compensatory Gait Deviations in CP Disclosure Information AACPDM 71st Annual Meeting | September 13-16, 2017 Speaker Names: Sylvia Ounpuu, MSc and Kristan Pierz, MD Differentiating Between Primary, Secondary Disclosure of Relevant Financial Relationships: and Compensatory Mechanisms in Gait in We have no financial relationships to disclose. Persons with Cerebral Palsy Disclosure of Off-Label and/or investigative uses: We will not discuss off label use and/or investigational use in our presentation. Sylvia Õunpuu, MSc and Kristan Pierz, MD Center for Motion Analysis Division of Orthopaedics Connecticut Children’s Medical Center Farmington, Connecticut Purpose Pathological Gait To describe gait pathology in CP in terms of primary, secondary and compensatory deviations. video Compensation Objectives: Secondary Deviation • Define primary and secondary deviations and Primary compensations seen in gait Deviation Primary • Differentiate between primary deviations that Deviation need to be treated and other gait deviations that Primary Deviation will resolve if the primary problem is addressed Primary Secondary • Understand common multi-level gait patterns in Deviation Deviation CP • Describe how motion analysis can help us Compensation understand primary vs. secondary gait deviations Primary Deviation AACPDM 2017 - IC #3 1 Primary, Secondary and Compensatory Gait Deviations in CP Outline Angle definition • Review of fundamentals for joint kinematics • The specific body including angle definitions and plotting segments that
    [Show full text]